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Monthly Archives: December 2017

Clinical Presentation: Every year throughout the world more than 5 million people-most of them kids younger than 1 year-die of acute infectious looseness of the bowels. Although death is really a uncommon outcome of infectious diarrhea within the United States, morbidity is substantial.

It is estimated that you will find more than 200 million episodes each year, resulting in 1.8 million hospitalizations at a price of $6 billion per year. The morbidity and mortality attributable to diarrhea are largely due to loss of intravascular volume and electrolytes, with resultant cardiovascular failure. For example, adults with cholera can excrete a lot more than 1 L of fluid per hour.

Contrast this with the typical volume of fluid lost daily within the stools (150 mL), and it is clear why massive fluid losses connected with infectious diarrhea can lead to dehydration, cardiovascular collapse, and death. Gastrointestinal (GI) tract infections can present with primarily upper tract symptoms (nausea, vomiting, crampy epigastric pain), small intestine symptoms (profuse watery diarrhea), or large intestine signs or symptoms (tenesmus, fecal urgency, bloody looseness of the bowels).

Etiology: A wide range of viruses, bacteria, fungi, and protozoa can infect the GI tract. However, in the majority of instances, symptoms are self-limited, and diagnostic evaluation isn’t performed. Individuals presenting to medical attention are biased toward the subset with more severe signs or symptoms (eg, high fevers or hypotension), immunocompromise (eg, HIV or neutropenia), or prolonged duration (eg, chronic diarrhea defined as lasting 14 days). An exception is large outbreaks of food-borne sickness, in which epidemiologic investigations may detect individuals with milder variants of illness.

Pathogenesis: A comprehensive approach to GI tract infections starts using the classic host-agent-environment interaction model. A quantity of host elements influence GI tract infections. Individuals at extremes of age and with comorbid conditions (eg, HIV infection) are at higher risk for symptomatic infection.

Medications that alter the GI microenvironment or destroy typical bacterial flora (eg, antacids or antibiotics) also predispose individuals to infection. Microbial agents responsible for GI sickness could be categorized according to kind of organism (bacterial, viral, protozoal), propensity to attach to various anatomic sites (stomach, little bowel, colon), and pathogenesis (enterotoxigenic, cytotoxigenic, enteroinvasive).

Environmental elements can be divided into three broad categories based on mode of transmission : (1) water borne, (2) foods borne, and (three) individual to person. GI tract infections can involve the stomach, leading to nausea and vomiting, or affect the small and large bowel, with looseness of the bowels as the predominant symptom.

The term “gastroenteritis” classically denotes infection of the stomach and proximal little bowel. Organisms causing this disorder consist of Bacillus cereus, S aureus, and a quantity of viruses (rotavirus, norovirus). B cereus and S aureus produce a preformed neurotoxin that, even in the absence of viable bacteria, is capable of causing disease, and these toxins represent major leads to of foods poisoning.

Although the exact mechanisms are poorly understood, it’s thought that neurotoxins act locally, through stimulation of the sympathetic nervous system having a resultant improve in peristaltic activity, and centrally, through activation of emetic centers within the brain. The spectrum of diarrheal infections is typified by the diverse clinical manifestations and mechanisms via which E coli can trigger diarrhea.

Colonization from the human GI tract by E coli is universal, usually occurring within hours following birth. Nevertheless, when the host organism is exposed to pathogenic strains of E coli not normally present in the bowel flora, localized GI illness or even systemic sickness may occur.

You will find five major classes of diarrheogenic E coli: enterotoxigenic (ETEC), enteropathogenic (EPEC), enterohemorrhagic (EHEC), enteroaggregative (EAEC), and enteroinvasive (EIEC). Functions typical to all pathogenic E coli are evasion of host defenses, colonization of intestinal mucosa, and multiplication with host cell injury.

This organism, like all GI pathogens, should survive transit via the acidic gastric environment and be able to persist within the GI tract despite the mechanical force of peristalsis and competition for scarce nutrients from existing bacterial flora. Adherence can be nonspecific (at any part from the intestinal tract) or, a lot more commonly, particular, with attachment occurring at well-defined anatomic areas.

Once colonization and multiplication happen, the stage is set for host injury. Infectious diarrhea is clinically differentiated into secretory, inflammatory, and hemorrhagic kinds, with different pathophysiologic mechanisms accounting for these diverse presentations. Secretory (watery) diarrhea is caused by a quantity of bacteria (eg, Vibrio cholerae, ETEC, EAggEC), viruses (rotavirus, norovirus), and protozoa (Giardia, Cryptosporidium).

These organisms attach superficially to enterocytes in the lumen of the small bowel. Stool examination is notable for the absence of fecal leukocytes, even though in uncommon instances there’s occult blood in the stools. Some of these pathogens elaborate enterotoxins, proteins that improve intestinal cyclic adenosine monophosphate (cAMP) production, primary to net fluid secretion. The classic example is cholera.

The bacterium V cholerae creates cholera toxin, which leads to prolonged activation of epithelial adenylyl cyclase within the small bowel, primary to secretion of massive amounts of fluid and electrolytes into the intestinal lumen. Clinically, the patient presents with copious diarrhea (“rice-water stools”), progressing to dehydration and vascular collapse without having vigorous volume resuscitation.

ETEC, a common trigger of acute diarrheal sickness in young kids and the most typical trigger of looseness of the bowels in travelers returning to the United States from developing countries, creates two enterotoxins. The heat-labile toxin (LT) activates adenylyl cyclase in a manner analogous to cholera toxin, whereas the heat-stable toxin (ST) activates guanylyl cyclase activity.

Inflammatory diarrhea is really a result of bacterial invasion of the mucosal lumen, with resultant cell death. Patients with this syndrome are usually febrile, with complaints of crampy lower abdominal discomfort as nicely as diarrhea, which might contain visible mucous. The term dysentery is utilized when there are substantial numbers of fecal leukocytes and gross blood.

Pathogens connected with inflammatory looseness of the bowels consist of EIEC, Shigella, Salmonella, Campylobacter, and Entamoeba histolytica. Shigella, the prototypical trigger of bacillary dysentery, invades the enterocyte through formation of an endoplasmic vacuole, which is lysed intracellularly. Bacteria then proliferate within the cytoplasm and invade adjacent epithelial cells.

Production of a cytotoxin, the Shiga toxin, leads to local cell destruction and death. EIEC resembles Shigella both clinically and with respect towards the mechanism of invasion of the enterocyte wall; however, the specific cytotoxin associated with EIEC has not yet been identified. Hemorrhagic diarrhea, a variant of inflammatory diarrhea, is primarily triggered by EHEC.

Infection with E coli O157:H7 has been connected with a quantity of deaths from the hemolytic-uremic syndrome, with a number of well-publicized outbreaks related to contaminated foods. EHEC leads to a broad spectrum of clinical disease, with manifestations including (1) asymptomatic infection, (2) watery (nonbloody) looseness of the bowels, (three) hemorrhagic colitis (bloody, noninflammatory diarrhea), and (4) hemolytic-uremic syndrome (an acute illness, primarily of children, characterized by anemia and renal failure). EHEC doesn’t invade enterocytes; nevertheless, it does create two Shiga-like toxins (Stx1 and Stx2) that closely resemble the Shiga toxin in structure and function. After binding of EHEC towards the cell surface receptor, the A subunit of the Shiga toxin catalyzes the destructive cleavage of ribosomal RNA and halts protein synthesis, leading to cell death.

Clinical Manifestations: Clinical manifestations of GI infections vary depending on the on website of involvement For instance, in staphylococcal foods poisoning, symptoms develop several hours after ingestion of foods contaminated with neurotoxin-producing S aureus. The symptoms of staphylococcal food poisoning are profuse vomiting, nausea, and abdominal cramps.

Diarrhea is variably present with agents leading to gastroenteritis. Profuse watery (noninflammatory, nonbloody) diarrhea is connected with bacteria that have infected the small intestine and elaborated an enterotoxin (eg, Clostridium perfringens, V cholerae). In contrast, colitis-like symptoms (lower abdominal pain, tenesmus, fecal urgency) and an inflammatory or bloody diarrhea occur with bacteria that more generally infect the large intestine.

The incubation period is usually longer (> 3 days) for bacteria that localize towards the large intestine, and colonic mucosal invasion can occur, causing fever, bacteremia, and systemic symptoms.

The power tools of today are not the same as the ones that were carefully placed on the pegboard near your grandfather’s workbench- they are actually quite far from it. Modern technology has made amazing advances in the simplest of features, including automatic shut-off, enhanced guarding and more resilient materials just to name a few. But one trait has come to be worth its weight in gold within the power tool industry, and that’s the owner’s manual.

Today’s manuals not only have better graphics showing its users what each part of the device should look like (and what to do when it doesn’t), many individual manufacturers will have explicit directions and instructions for the safety and maintenance of each individual power tool. Of course, no instructions are completely fool proof, especially if the content of such manuals isn’t completely understood by the user. This is why many manufacturers have implemented training seminars and classes for both companies and individuals on the proper procedures for optimum performance and safety. Local home improvement stores often hold such classes and seminars on a regular basis.

However, a bit of common sense and know-how never hurt anyone, so there are a few safety guidelines which should be followed by all users of power tools. For example, wearing the proper clothing is essential, and you should never wear loose clothing that could easily get caught in a power tool. Safety gear is crucial- hard hat, safety goggles and gloves, along with the proper footwear. Using the right tool, whether it be size or something else, for the job at hand, including the right type of extension cord (indoor, outdoor, proper length) if applicable. The work area should be clean, uncluttered and well lit. Keep all electric tools away from water and flammables. Do not use power tools with frayed or damaged cords. Damaged parts anywhere in a power tool, including saw blades and drill bits, can cause damage to the tool itself or the individual performing the task. Unplug all electric power tools when finished with or before changing to another tool.

As far as the maintenance aspect of such power tools, common sense is again of the highest importance. For example, making sure that the proper guards are placed on saw blades when not in use is both a safety and maintenance issue. Saw blades need to be sharp to deliver the best performance possible, but can also be incredibly dangerous, so taking the proper preventive measures will yield the best results in all aspects, not just project outcome.

For more information on power tool basics, the U.S. government has many publications that can be of high value to consumers. The U.S. Consumer Product Safety Commission offers product recall information, and OSHA has a few such publishings regarding both general industry and personal use of power tools.

Learning to drive is not the easiest thing to do, especially if you are a young person. Whether you are young or a little older and trying to get your license, you need to be aware that it is possible to learn how to drive online.

The internet is a very powerful tool and just about anything can be learned on it very easily. Driving is no exception. While formal drivers education classes are certainly needed and highly recommended, there are resources online that can help you learn just as much or even more than you would from a regular in-person class.

The best product that I have ever come across to help people learn how to drive online is a video education course called Get Ready To Pass. I have done an in depth review of it and found it to be extremely effective.

The reason why I liked this product so much is because it gives the user all the tools that are needed to succeed and pass the road driving test the very first time. About half of people who attempt their road test fail on their first try. I know this because I was one of them!

I could have really used the resources given by this online drivers education website and helped myself be more prepared. It would have certainly been worth sparing the embarrassment I felt having to tell my friends that I could not drive good enough to pass.

In closing, it is totally possible to learn how to drive online if you want to. I recommend an online course that includes videos and has a solid customer base of people whom it has worked for. I know that I definitely could have used the help!

Education is a systematic process of acquiring knowledge and skill necessary for personal growth and development. The practical application of education in a specific field of study can jumpstart a professional career or establish a foundation for possible business ventures. Making an investment in education can be one of your most significant and wisest decisions in life because of its immediate impact to your future. Distance education plays a vital role in connecting educators and learners worldwide, breaking the barriers imposed by time constraints, distance, disabilities and socio-economic status. Distance education courses are being offered by Open Institutions to answer the call for internationally recognised quality education and training. Whether you are a student who just started on the path of learning, a professional in your field of study and want to further your education through advanced and specialized programs, or a person who is restricted by travel or health concerns, online courses definitely have the answers for you.

Many individuals are asking on how effective distance education when delivering the methodologies of teaching. Online education classes are as effective as traditional face-to-face instruction done in colleges and universities. The keys to establishing a successful online study depend on the dedication and focus of the learner, and timely peer-support by the open institution. The people behind the curriculum and online support offered through distance education are professionals and experts in their field, so you can be sure of having the quality education and training that you are looking for. Online instruction is divided into four major classifications, namely: voice, video, data and print. Voice or use of audio as medium of communication includes the telephone, tapes, radio and audio-conferencing.

On the other hand, videos may come in the form of instructional tapes or CDs, or combined with voice and data as file attachments. Print media can be in the form of instructional books, guides, course outlines or assessments which are delivered through courier or mailing system. Data is the widely used form of instruction due to the advances in technology in computers and the internet. Information is transmitted electronically and may be in the form of Computer Assisted Instruction (CAI), Computer Managed Instruction (CMI), Computer Mediated Education (CME), or a combination of any of these. The delivery of education and training became better, faster and economical since all the instructional materials and methods of teaching are coursed through e-mail (electronic email) or e-fax (electronic facsimile), online conferencing and other World-Wide Web applications. This would include advances in communication by utilizing Voice over Internet Protocol (VoIP). By making use of all the available communication media, online learning study is delivered fast and efficient.

Distance learning has many advantages that individuals on different levels of learning can take advantage. It provides the flexibility of choice when you want to finish a course or where you want the training to take place. Assessments and projects are given at the end of a specified topic, submitted to education professionals and experts of their field for evaluation, and then feedback is given to determine if a learner is to advance to the next level or if further reading is required prior to advancement. You can never be too old or too young in order to start a life changing career, or build the basic foundation to start a new business. All you would need is the proper self-motivation and focus so you can look forward and fulfill your dreams in life.

My 15-year-old nephew asked me, “How and where to practice and develop one of the working skills during school time?” My first thought, at that moment, was “College radio station”.

At 16, I joined my college radio station and began my job as an editor for an online music program. From that day, I have become acquainted with terms such as noise, sound, broadcast, frequency and so on. Luckier than many people, with that job, I could earn money for my living, besides gaining very much experience and building up many good relationships which can support my current and future career. And with such experience, now, I can give advice to my nephew or any youth who wants to start a career and develop their skill, knowledge in working.

Well, let me think about what we need for a college radio station. If just listing out, we might think that it’s too simple and easy: a studio, or source of program, and the transmission lines. If you are beginners, don’t think you can do much and all but step by step. It was really difficult at that time when we began with various odd pieces of equipment. We started using the easiest means of transmission by broadcasting in the school canteen, in classes. And later, we added more ways to reach the audience. We concentrated on serving our school and at the same time extended to other colleges in the same area. Actually, the running of our school radio station was based on fund-raising and sponsorship money. Besides some necessary equipment such as Mini-discs, computers, recorders, we faced a bigger problem for a long time looking for an old, affordable multi-track mixer. We didn’t have the advanced and efficient equipment to support our work.

The first broadcasting show of ours was a two-hour program divided into 3 smaller sections. The first one was “Hello Morning” with 3 tiny bulletins of 3 to 5 minutes each. In these bulletins, we presented all good and happy news. The second section was “Music Dedication Program”. We compiled a few collections of music and one by one was presented everyday. The third one was “School loud speaker” during which we announced important events of the school for the following week. Day by day, the program was extended and the coverage of the program was enlarged.

We received more orders from many schools for radio storytellers, puppeteers, live music programs, music festivals, and etc. The students who worked in the radio station were really in situation in which we could practice and develop the skills of drawing up plans, solving problems, devising strategies and many more. Two years later, our radio station was presented with a big gift from a local station: a voice changer software and a music editor software. These advanced softwares helped us handle our job properly. Instead of needing many students to join in dubbing for a story or a drama, now, we just need two “technical operators” and two students to make the dubbing. The old weak multi-track mixer was “retired” and the music editor.

We learnt how to apply these efficient tools in work. Of course, we found them very useful and interesting. We could easily record, remix music, add sound and effects, change one voice into many others. These jobs used to require many people and much time . However, applying our computers and these softwares, we could do the job well with just 4 or 5 people.

We spent much time, thought and labor in this extra-curriculum job, but we loved it. We made school lessons more interesting and exciting. We created a different way for children to gain experience and helped them make a presentation in a new way. We made a radio program which was considered the “voice” of students, pupils in the school. We sent meaningful music messages to friends, teachers, and so on.

I join my current company, a provider of voice changer and music editor softwares, because of many reasons. One of these reasons is that I want to support many college radio stations. My friends who used to work with me in our school radio station are all having good jobs in professional.

We are very happy to give advice and guidelines to youth in starting a school radio station or a home music studio.

One of the first advices from me is that “Don’t wait until tomorrow what you can do today”. Seize any chance you have, start with your dream, step by step, and you can see a clearer road for your future.

There are many different types of warts, all of which have one thing in common… they are embarrassing, unpleasant, cosmetically unattractive, unwanted, annoying and sometimes painful protrusions that appear on the skin almost anywhere. They have always been considered ugly and in folklore over the years… witches have usually modelled a whole host of various ‘warty’ protrusions on various parts of their anatomy. In fact the larger the wart… the more evil the witch! The princess never had warts… the wicked stepmother had them though! The ‘goodies’ never sported a fashionable wart but the baddies were regularly seen displaying one or more particularly heinous ones.

What are warts and why do we get them?

They are completely benign epidermal tumors or growths on the skin and most of them are highly contagious. They originate from the human papilloma virus (HPV) which causes the infection and more than 100 HPV subtypes are known.

Warts are particularly common in childhood and are spread by direct contact or by touching itching and spreading through touch. If a wart is scratched, the viral particles may be spread to another area of skin. It can take as long as twelve months for the wart to first appear and they can just as easily spontaneously disappear temporarily or even permanently. The majority of them have a hard surface and a tiny black dot in the middle or each warty mark can often be seen. This is a capillary blood vessel seen through the skin. Warts can develop individually or in clusters and can spontaneously disappear. Hygiene must be of the highest importance to avoid cross infection and if not treated they may spread.

In children, even without treatment, some warts disappear within 6 months and up to 90% are gone in 2 years. They are more persistent than this in adults but they can sometimes disappear of their own accord.

Warts are particularly numerous and troublesome in patients that are immuno-suppressed.

There are many types of warts:

1. Common warts arise most often on the backs of fingers or toes, palms of hands and on the knees.

2. Plantar warts (verrucas) are seen on the foot – mainly on the sole of the foot.

3. Mosaic warts are also seen on the sole of the foot and appear in clusters over an area often proliferating to several centimeters in diameter. Many little dots from capillaries underneath the surface of the skin can be seen throughout mosaic warts.

4. Plane, or flat, warts are often seen on the face or limbs and under the arms and can be very numerous.

5. Periungual warts grow at the sides or under the nails and can distort nail growth if left. Treatment can be difficult because of the sensitivity of the area and the risk of damaging the nail bed.

6. Filiform warts are on a long stalk and these can appear quite often on the face where they are a most upsetting and cosmetically unattractive addition. They often have a multi faceted top like finger like projections which are very dry and crusty.

7. Oral warts can affect the lips and even inside the cheeks. They include Squamous Cell Papillomas (not to be confused with Squamous Cell Carcinomas), are small benign (non-cancerous) growth that begin in squamous cells (thin, flat cells) that are found in the tissue that forms the surface of the skin (epidermis), the passages of the respiratory and digestive tract and in the lining of hollow organs of the body.

8. Genital warts are very common. There are at least 100 different types of HPV and at least 40 can infect the genital area they are often transmitted sexually and predispose to cervical, penile and vulval cancers.

Treatment Options:

Warts are not a serious health condition and many people will not bother to treat them as often the treatment is uncomfortable and requires considerable effort. To get rid of them, the body’s own immune system has to be stimulated to attack the wart virus. Persistence with the treatment and patience is essential!

There are several options of treatment, some more successful than others.

Electrolysis

Electrolysis has been around for over 130 years for hair removal but is fairly new to wart treatment but is proving high successful and illustrating excellent results. It is a very precise form of treatment not unlike Electrosurgery (curettage and cautery) but is gentler and less invasive. Treatment techniques depend upon the type of wart but with a common wart the tiny electrolysis needle (about the size of a eyelash) is used to cauterise the surface of the skin over the affected area. This is then inserted into the centre of the wart where a high frequency, radio frequency current is expelled. Following treatment the surface of the wart will scab over, which will, after a week or so, slough away leaving perfect skin behind. More than one treatment may be required with verrucas in particular being very resilient and definitely needing more than one treatment.

Other methods of treatment include:

Occlusion. By covering the wart 24 hours of the day may result in it clearing. Duct tape is often used.

Chemical treatment. Chemical treatment includes wart paints containing salicylic acid which remove the dead surface skin cells. Perseverance is essential as it can take 12 weeks to go or more likely to reduce in size.

Cryotherapy. The wart is repeatedly frozen with liquid nitrogen resulting in blistering, swelling and sometimes permanent white scarring following treatment.

Electrosurgery (curettage & cautery) is used for particularly large and annoying warts. Under local anaesthetic, the growth is pared away and the base burned by diathermy or cautery. The wound heals in about two weeks.

Other treatments. There are numerous treatments for warts and none offer a guarantee of cure. They include: Topical creams, oral medication, vaporisation, pulse dye laser destruction of feeding blood vessels and even duck tape and banana skin are home care options.

Window tinting films are measured in visible light transmission levels (or VLT). This means that when we discuss a particular film, be it for fitting to a car or any other application, we normally refer to it with it’s VLT value. VLT is measured in percentage ( % ), so if you hear about a tint product being referred to as a percentage, it is the VLT that defines that percentage value.

For example, a tinting film referred to as Charcoal 5% is a charcoal coloured tint with a VLT of 5% and likewise a film referred to as green 50% is a green coloured tint film with a VLT of 50%. But what does the number actually mean?

Well, in simple terms the VLT value is the percentage of visible light that will be allowed to travel through the window tinting film from the exterior face side of the film to the interior side. This means that a 5% film will only allow 5% light travel through and a 70% film will allow 70% light to travel. In effect, this means that lower VLT films will appear darker. For instance, it is normally 5% tints that we will see on limousines for privacy.

So, fitting a 5% tint to a window will allow 5% light to travel through the glass from outside to inside, right? NO! Because we need to take into consideration the actual VLT of the window before the tint is even installed. There is no such thing as a piece of glass, no matter how clear it appears, with a VLT of 100%. This is because glass naturally filters out a little bit of visible light.

Lets look at car window tinting as this is one area where we speak of VLT often due to the fact that many countries have laws in place limiting how dark car windows should be tinted. Most modern cars come from factory with windows reading a VLT somewhere between 72% and 78%, depending on manufacturer, model and country. Say, our example car’s windows read at 72% and we add a 50% window tinting film, what is the new and final VLT of our car’s windows after installation?

The sum is very simple: V1 x V2 = V3 (Where V1 is the original VLT of the glass before tinting, V2 is the VLT of the window tinting film and V3 is the final VLT value of the glass with tint film applied).

In our daily life, motorcycles are also catch people’s attention except for cars and bicycles. They are important transportation mode that we can not ignore. Motorcycles have been developed a lot through these years. Modern types are quite different from the earlier ones for that they can include high-tech components.

It is common that every product should depend on various parts to achieve the expected function, so do the motorcycles. They also need specific parts to function properly. Different components work together to keep the motorcycles in a good condition.

One of the most obvious and important parts is the wheel. Generally, there are two wheels on a motorcycle which featured steel spokes traditionally. But through the development, many other types can be found now such as the cast aluminum wheels and other alloy models. Usually, rear wheels may be larger and wider than front wheels because of their drive configuration.

Drivetrain is just like the heart of the motorcycle. It is powered by the drivetrain which includes the engine. Motorcycle engines are usually centrally mounted below the driver’s seat. It conveys power to the rear drive wheel through its transmission . The transmission itself is attached to the engine, and operated by a shift lever and a clutch. And the system connecting the transmission to the rear wheel (the final drive) varies on different types of motorcycles, and may be a chain or belt, or a solid shaft.

Brakes are also necessary components on a motorcycle. They are controlled by a hydraulic system that is activated by handlebar or foot levers. Typically, disc brakes are offered on high end models or heavier motorcycles that require more powerful brakes.

Electrical system is an indispensable part. Sometimes, it is very complex. Some of the most basic electrical components are the lights, which include the headlights, tail lights, directional signals and brake lights. In addition, the instrumentation which includes the speedometer, tachometer and odometer is also an important part of this system.

Of course, there are still many other parts which also have significance to the motorcycles. They may be added to distinguish one model from another, or to prepare a motorcycle for a certain type of driving. All in all, all of the motorcycle parts are important for the proper function of the whole machine.